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第一产程活跃期经会阴超声对初产妇分娩方式的预测价值

魏玉新 梁舒雯 陈醇 李秀玲 朱姝 颜芳

魏玉新, 梁舒雯, 陈醇, 李秀玲, 朱姝, 颜芳. 第一产程活跃期经会阴超声对初产妇分娩方式的预测价值[J]. 昆明医科大学学报, 2022, 43(9): 38-42. doi: 10.12259/j.issn.2095-610X.S20220908
引用本文: 魏玉新, 梁舒雯, 陈醇, 李秀玲, 朱姝, 颜芳. 第一产程活跃期经会阴超声对初产妇分娩方式的预测价值[J]. 昆明医科大学学报, 2022, 43(9): 38-42. doi: 10.12259/j.issn.2095-610X.S20220908
Yuxin WEI, Shuwen LIANG, Chun CHEN, Xiuling LI, Shu ZHU, Fang YAN. Prediction of Delivery Mode by Transperineal Ultrasound during the Active Phase of the First Stage Labor[J]. Journal of Kunming Medical University, 2022, 43(9): 38-42. doi: 10.12259/j.issn.2095-610X.S20220908
Citation: Yuxin WEI, Shuwen LIANG, Chun CHEN, Xiuling LI, Shu ZHU, Fang YAN. Prediction of Delivery Mode by Transperineal Ultrasound during the Active Phase of the First Stage Labor[J]. Journal of Kunming Medical University, 2022, 43(9): 38-42. doi: 10.12259/j.issn.2095-610X.S20220908

第一产程活跃期经会阴超声对初产妇分娩方式的预测价值

doi: 10.12259/j.issn.2095-610X.S20220908
基金项目: 云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目[2019FE001(-290),2019FE001(-126),202001AY070001-123];云南省医疗卫生单位内设研究机构基金资助项目(2018NS0239,2018NS0240);云南省妇产疾病临床医学研究中心基金资助项目(202002AA100199,2022YJZX-FC19)
详细信息
    作者简介:

    魏玉新(1982~),女,云南建水人,在读硕士研究生,主治医师,主要从事产前超声诊断工作

    通讯作者:

    颜芳,E-mail:khyanfang@vip.sina.com

  • 中图分类号: R714.3

Prediction of Delivery Mode by Transperineal Ultrasound during the Active Phase of the First Stage Labor

  • 摘要:   目的  探讨第一产程活跃期时产程进展角(angle of progression,AOP)、胎头下降距离(progression distance,PD)、胎头至耻骨联合距离(head-symphysis distance,HSD)等产程进展参数对分娩方式的预测价值。  方法  选取2020年7月到2021年12月在云南省第一人民医院产科经阴道试产的初产妇作为研究对象,在第一产程活跃期测量其AOP、PD、HSD,比较阴道分娩组与剖宫组之间上述参数的差异,应用ROC曲线分析各产程进展参数对孕妇分娩方式的预测价值。  结果  阴道分娩组孕妇在第一产程活跃期AOP及PD明显大于剖宫产组,[(141.09±9.87)° vs (122.84±10.70)°]、[(4.28±0.48) cm vs (3.18±0.83) cm],而HSD阴道分娩组则明显小于剖宫产组[(1.42±0.40) cm vs( 2.18±0.64) cm],差异均有统计学意义(P < 0.001);ROC曲线分析显示,AOP、PD、HSD预测阴道分娩的曲线下面积分别为0.892、0.875、0.840,差异均有统计学意义(P < 0.001)。  结论  对经阴道试产初产妇,第1产程活跃期AOP、PD及HSD的测量对分娩方式具有预测价值。
  • 图  1  经会阴超声测量

    Figure  1.  The measurement of AOP,PD and HSD by intrapartum translabial ultrasound A:AOP;B:PD;C:HSD。

    图  2  AOP、PD、HSD预测阴道分娩的ROC曲线

    Figure  2.  The ROC curve of AOP、 and HSD for predicting vaginal delivery

    表  1  阴道分娩组和剖宫产组之间一般情况的比较($\bar x \pm s $

    Table  1.   The difference of basic characteristics between the vaginal delivery group and the cesarean section group ($\bar x \pm s $

    临床特征阴道分娩组剖宫产组tP
    年龄(岁) 28.67 ± 3.51 28.84 ± 4.12 −0.273 0.785
    体重(kg) 67.90 ± 9.24 67.97 ± 6.78 −0.042 0.966
    体重指数(kg/m2 26.36 ± 3.40 26.93 ± 2.65 −1.021 0.309
    胎儿头围(cm) 32.60 ± 1.17 33.02 ± 0.93 −2.234 0.027*
    出生体重(g) 3232 ± 396 3429 ± 378 −2.945 0.004*
      * P < 0.05。
    下载: 导出CSV

    表  2  阴道分娩组和剖宫产组之间各产程进展参数的比较($\bar x \pm s $

    Table  2.   The difference of labor progression parameters between the vaginal delivery group and the cesarean section group ($\bar x \pm s $

    组别AOP(°)PD(cm)HSD(cm)
    阴道分娩组
    n = 158)
    141.09 ± 9.87 4.28 ± 0.48 1.42 ± 0.40
    剖宫产组
    n = 44)
    122.84 ± 10.70 3.18 ± 0.83 2.18 ± 0.64
    t 10.64 11.25 −9.69
    P < 0.001* < 0.001* < 0.001*
      *P < 0.05。
    下载: 导出CSV

    表  3  产程进展参数对分娩方式(阴道分娩)的预测效能

    Table  3.   The value of these parameters in predicting the mode of delivery

    产程进展参数AUC截断值灵敏度
    (%)
    特异度
    (%)
    P95%置信区间
    下限上限
    AOP 0.892 132.95° 80.4 86.4 < 0.001* 0.833 0.951
    PD 0.875 3.65 cm 90.5 68.2 < 0.001* 0.816 0.934
    HSD 0.840 1.75 cm 84.8 68.2 < 0.001* 0.773 0.907
      *P < 0.05。
    下载: 导出CSV
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  • 收稿日期:  2022-05-07
  • 网络出版日期:  2022-09-07
  • 刊出日期:  2022-09-29

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